Articles: disease.
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A system has been established to document births and deaths in children in a large, rural, West African population, using community reporters. Causes of death in children under the age of 5 years were investigated using post-mortem questionnaires completed by field assistants. There was a marked seasonal incidence of all major causes of death with peak rates in the rainy season. ⋯ Other major causes of death were malaria, acute gastro-enteritis and chronic diarrhoea with malnutrition. Mortality from all the major causes of death decreased with increasing village size. Our findings have implications for interventions against childhood mortality.
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A community development approach has been adopted in the outreach component of the work of the Alexandra Health Centre in South Africa. The importance of local township organizations has been recognized and the Centre is seen not only as providing technical solutions but also as helping people to achieve improved living conditions. This requires clear motivation, rigorous management, purposeful action by teams of health staff, and planning in conjunction with the community.
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Bull. World Health Organ. · Jan 1993
Assessment of respiratory rate and chest indrawing in children with ARI by primary care physicians in Egypt.
In a baseline study for training purposes, two indicators of acute respiratory infections (the respiratory rate (RR) and chest indrawing) were assessed by Ministry of Health physicians in Egypt using a WHO test videotape. Chest indrawing, as defined by the WHO Acute Respiratory Infections (ARI) programme, was not widely recognized by current health personnel. Viewing a WHO training videotape led to significantly more correct assessments of chest indrawing compared with a group that had not viewed this videotape. ⋯ Rates counted over 60 seconds were more accurate than 30-second counts although the difference between them was not clinically significant. Counting of rates using timers with audible cues was comparable to using watches with second hands. Careful training of primary health workers in the assessment of RR and chest indrawing is essential if these clinical findings are to be used as reliable indicators in pneumonia treatment algorithms.
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We report here on a child who over a period of 8 years was admitted several times to hospitals in different states of Nigeria based on fictitious illnesses described by his mother. The child had various unnecessary, expensive and invasive investigations followed by treatment with harmful drugs. The evolution of this case of Munchausen syndrome by proxy is described in order to alert paediatricians in developing countries to a problem which is described frequently in more affluent societies. We believe this is the first such case to be recorded in West Africa.
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Female sexual partners of injection drug users are at risk for AIDS because of their association with street drug cultures and all their concomitant risks, including their own non-injecting drug use. This study examines a model of the social determinants of HIV-associated sexual risk behaviors. ⋯ The findings show that crack cocaine use is the strongest contributor to the model, which explains fourteen percent of the variance of sexual risk behavior. The findings suggest that the risks associated with sexual practices are much greater for crack cocaine users than among non users of crack.